scholarly journals Triage for Malnutrition Risk among Pediatric and Adolescent Outpatients with Cystic Fibrosis, Using a Disease-Specific Tool

Children ◽  
2020 ◽  
Vol 7 (12) ◽  
pp. 269
Author(s):  
Dimitrios Poulimeneas ◽  
Maria G. Grammatikopoulou ◽  
Argyri Petrocheilou ◽  
Athanasios G. Kaditis ◽  
Tonia Vassilakou
Keyword(s):  
Cystic Fibrosis ◽  
Lung Function ◽  
Risk Group ◽  
Ideal Body Weight ◽  
Forced Expiratory Volume ◽  
Adverse Outcomes ◽  
The Body ◽  
Moderate Risk ◽  
Cross Sectional ◽  
Disease Specific

Malnutrition prevails in considerable proportions of children with Cystic Fibrosis (CF), and is often associated with adverse outcomes. For this, routine screening for malnutrition is pivotal. In the present cross-sectional study, we aimed to assess the risk for malnutrition in pediatric outpatients with CF. A total of 76 outpatients (44 girls, 11.9 ± 3.9 years old, 39.5% adolescents) were recruited and anthropometric, clinical, dietary and respiratory measures were collected. All outpatients were screened for malnutrition risk with a validated disease-specific instrument. Most children exhibited a low risk for malnutrition (78.9%), whereas none of the participants were characterized as having a high malnutrition risk. In the total sample, malnutrition risk was positively associated with age (r = 0.369, p = 0.001), and inversely related to the body mass index (r = −0.684, p < 0.001), height z-score (r = −0.264, p = 0.021), and forced expiratory volume (FEV1%, r = −0.616, p < 0.001). Those classified as having a low malnutrition risk were younger (p = 0.004), heavier (p < 0.001) and taller (p = 0.009) than their counterparts with a moderate risk. On the other hand, patients in the moderate risk group were more likely pubertal (p = 0.034), with a reduced mid-upper arm fat area (p = 0.011), and worse pulmonary function (p < 0.001). Interestingly, none of the children attaining ideal body weight were classified as having a moderate malnutrition. risk, whereas 37.5% of the patients allocated at the moderate risk group exhibited physiological lung function. In this cohort of outpatients with CF that were predominantly well-nourished and attained physiological lung function, malnutrition risk was identified only in small proportions of the sample. Our data support that patients that are older, pubertal, or have diminished fat mass are at greater risk for malnutrition.

scholarly journals Prevalence and impact of oprD mutations in Pseudomonas aeruginosa strains in cystic fibrosis

2019 ◽  
Author(s):  
Laura J. Sherrard ◽  
Bryan A. Wee ◽  
Christine Duplancic ◽  
Kay A. Ramsay ◽  
Keyur A. Dave ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Pseudomonas Aeruginosa ◽  
Lung Function ◽  
Hazard Rate ◽  
Carbapenem Resistance ◽  
Adverse Outcomes ◽  
Nonsense Mutations ◽  
Allelic Variants ◽  
Novel Variants

ABSTRACTDefective OprD porins contribute to carbapenem resistance and may be important in Pseudomonas aeruginosa adaptation to cystic fibrosis airways. It is unclear whether oprD mutations are fixed in populations of shared strains that are transmitted between patients or whether novel variants arise during infection. We investigated oprD sequences and antimicrobial resistance of two common Australian shared strains, constructed P. aeruginosa mutants with the most common oprD allelic variants and compared characteristics between patients with or without evidence of infection with strains harbouring these variants. Our data show that three independently acquired nonsense mutations arising from a 1-base pair substitution are fixed in strain sub-lineages. These nonsense mutations are likely to contribute to reduced carbapenem susceptibility in the sub-lineages without compromising in vitro fitness. Not only was lung function worse among patients infected with strains harbouring the nonsense mutations than those without, but they also had an increased hazard rate of lung transplantation/death. Our findings further highlight that understanding adaptive changes may help to distinguish patients with greater adverse outcomes despite infection with the same strain.

scholarly journals Study on prediction of type 2 diabetes mellitus in undergraduate MBBS students: a cross-section study in a tertiary health center, Kolkata

2017 ◽  
Vol 6 (1) ◽  
pp. 184
Author(s):  
Murari M. Mandal ◽  
Shobhit Garg ◽  
R. N. Mishra ◽  
Swanya P. Maharana
Keyword(s):  
Type 2 Diabetes ◽  
Screening Tool ◽  
Risk Group ◽  
Cost Effective ◽  
High Risk Group ◽  
Hip Circumference ◽  
Moderate Risk ◽  
Cross Sectional ◽  
Random Blood Sugar

Background: Diabetes, is now a leading cause of morbidity and mortality worldwide. Prevalence of type-2 diabetes in children and adolescents is rapidly increasing worldwide. Adolescence and early youth period has pivotal importance for young people with diabetes risk when they usually start learning about how to take responsibility. With this background, present study was done to find out the proportion of various risk factors and future risk of developing diabetes among MBBS undergraduates in Kolkata.Methods: This study was a cross-sectional institution based study done from 1st June to 18th June 2017. Data was collected by interviewing each respondent with the help of structured pre-designed pre-tested schedule, after which clinical examination for height, weight, waist and hip circumference, blood pressure and RBS were done. Out of 150 undergraduates, 130 agreed to participate. Data was analysed with R software.Results: Mean age of the students was 20.45years. 48.5% of them were either overweight or obese. Nearly half of them had waist circumference and waist hip ratio in risk group. Only 65 were normotensive and 7 had high random blood sugar (≥140 mg/dl). 6 students were in high risk group according to both IDRS (≥60) and ADA (≥5) risk score. 66 students were in moderate risk (30-50) group as per IDRS risk score.Conclusions: The simple and cost-effective IDRS could serve as a screening tool health worker to identify at risk individuals at the earliest and enable primary prevention by encouraging these students to modify their life-style.

Investigating the Measurement of Physical Activity and Associated Factors in Youth and Adults with Cystic Fibrosis

2021 ◽  
Author(s):  
◽  
Mayara S. Bianchim
Keyword(s):  
Physical Activity ◽  
Cystic Fibrosis ◽  
Lung Function ◽  
Vigorous Physical Activity ◽  
The Body ◽  
Machine Learning Algorithms ◽  
Cut Points ◽  
Measurement And Analysis ◽  
The Relationship ◽  
Crucial Part

Cystic Fibrosis (CF) is a multisystemic condition that affects almost every organ in the body, but especially the lungs. Regular physical activity (PA) can significantly slow disease progression and has become a crucial part of CF care. Previous research evaluating PA in CF has been hindered by the use of cut-points developed for healthy populations and the investigation of collinear movement behaviours as independent entities, both of which are likely to have confounded their findings and any subsequent inferences regarding associated health outcomes. Therefore, the overall aim of this thesis was to investigate the measurement and analysis of PA in those with CF. An initial systematic review provided recommendations for research calibrating accelerometry in paediatric clinical populations, highlighting that the pathophysiology of the condition must be accounted for and that the protocol should include a broad range of activities varying in intensity (Chapter 4). Subsequently, Chapter 5 developed and cross-validated raw acceleration CF-specific cut-points in youth which were then further assessed in Chapter 6, demonstrating that the CF-specific thresholds were associated with higher levels of moderate-to-vigorous physical activity (MVPA) and sedentary time (SED) and lower levels of light PA compared to generic cut-points. Furthermore, lung function was associated with light PA when using condition-specific thresholds. Further investigation of the relationship between PA and health in Chapter 7 found that reallocating time from sedentary to any other behaviour was beneficial for lung function, with the greatest improvements observed when SED was reallocated to sleep or MVPA. Finally, Chapter 8 developed and validated machine learning algorithms that achieved excellent accuracy to classify PA types and intensities in youth with CF. In conclusion, these findings significantly advance the assessment of PA, enhancing our understanding of the relationship between PA and health in CF and informing future condition-specific PA guidelines, care strategies and interventions.

Cross-sectional and longitudinal associations between urinary zinc and lung function among urban adults in China

Thorax ◽  
2020 ◽  
Vol 75 (9) ◽  
pp. 771-779 ◽  
Author(s):  
Min Zhou ◽  
Lili Xiao ◽  
Shijie Yang ◽  
Bin Wang ◽  
Tingming Shi ◽  
...  
Keyword(s):  
Lung Function ◽  
Oxidative Damage ◽  
Systemic Inflammation ◽  
Secretory Protein ◽  
Forced Expiratory Volume ◽  
C Reactive Protein ◽  
Cross Sectional ◽  
Mediation Analyses ◽  
Reactive Protein

BackgroundExposure to zinc was suggested to be associated with pulmonary damage, but whether zinc exposure affects lung function remains unclear.ObjectivesTo quantify the association between urinary zinc and lung function and explore the potential mechanisms.MethodsUrinary zinc and lung function were measured in 3917 adults from the Wuhan-Zhuhai cohort and were repeated after 3 years of follow-up. Indicators of systemic inflammation (C reactive protein), lung epithelium integrity (club cell secretory protein-16) and oxidative damage (8-hydroxy-2′-deoxyguanosine and 8-isoprostane) were measured at baseline. Linear mixed models were used to estimate the exposure–response relationship between urinary zinc and lung function. Mediation analyses were conducted to assess mediating roles of inflammation and oxidative damage in above relationships.ResultsEach 1-unit increase in log-transformed urinary zinc values was associated with a 35.72 mL decrease in forced vital capacity (FVC) and a 24.89 mL decrease in forced expiratory volume in 1 s (FEV1) in the baseline analyses. In the follow-up analyses, there was a negative association between urinary zinc and FVC among participants with persistent high urinary zinc levels, with an estimated change of −93.31 mL (95% CI −178.47 to −8.14). Furthermore, urinary zinc was positively associated with restrictive ventilatory impairment. The mediation analyses suggested that C reactive protein mediated 8.62% and 8.71% of the associations of urinary zinc with FVC and FEV1, respectively.ConclusionUrinary zinc was negatively associated with lung function, and the systemic inflammation may be one of the underlying mechanisms.

scholarly journals Serum 25-hydroxyvitamin D levels and lung function in adults with asthma: the HUNT Study

2014 ◽  
Vol 45 (4) ◽  
pp. 1019-1026 ◽  
Author(s):  
Tricia L. Larose ◽  
Arnulf Langhammer ◽  
Yue Chen ◽  
Carlos A. Camargo ◽  
Pål Romundstad ◽  
...  
Keyword(s):  
Allergic Rhinitis ◽  
Lung Function ◽  
Vital Capacity ◽  
Forced Expiratory Volume ◽  
Health Study ◽  
Linear Regression Models ◽  
Cross Sectional ◽  
Hydroxyvitamin D ◽  
25 Hydroxyvitamin D ◽  
Hunt Study

The association between vitamin D status and lung function in adults with asthma remains unclear.We studied this cross-sectional association and possible modification by sex and allergic rhinitis in 760 adults (aged 19–55 years) with self-reported asthma in the Nord-Trøndelag Health Study. Serum 25-hydroxyvitamin D (25(OH)D) level <50 nmol·L−1was considered deficient. Lung function measurements included forced expiratory volume in 1 s (FEV1) % predicted, forced vital capacity (FVC) % predicted and FEV1/FVC ratio. Multiple linear regression models were used to estimate adjusted regression coefficients (β) and 95% confidence intervals.44% of asthma adults had serum 25(OH)D levels <50 nmol·L−1. Its associations with lung function measures seemed to be modified by sex and allergic rhinitis (p<0.03 for three-way interaction term). Overall, a serum 25(OH)D level <50 nmol·L−1was not associated with lung function measurements in subjects with allergic rhinitis in this asthma cohort. In men with asthma but without allergic rhinitis, however, a serum 25(OH)D level <50 nmol·L−1was significantly associated with lower FEV1/FVC ratio (β=−8.60%; 95% CI: −16.95%– −0.25%).Low serum 25(OH)D level was not associated with airway obstruction in most asthma adults with the exception of men with asthma but without allergic rhinitis.

Ambient air pollution exposure and lung function assessment of filling station attendants in Ibadan, Nigeria

2019 ◽  
Vol 34 (2) ◽  
pp. 211-218
Author(s):  
Toluwanimi Mobolade Oni ◽  
Godson R.E.E. Ana
Keyword(s):  
Air Pollution ◽  
Lung Function ◽  
Air Pollutants ◽  
Ambient Air ◽  
Forced Expiratory Volume ◽  
Ambient Air Pollution ◽  
World Health ◽  
Health Administration ◽  
Cross Sectional ◽  
Filling Station

Abstract Background There is an increasing range of adverse health effects associated with air pollution at very low concentrations. Few studies have assessed respiratory parameters among filling station attendants. Objectives This study assessed air pollutants; particulate matter (PM10) and total volatile organic compounds (TVOC) concentrations at filling stations as well as determined forced expiratory volume in one second (FEV1) and peak expiratory flow rate (PEFR) levels among filling station attendants. Methods A cross-sectional study was conducted to assess PM10 and TVOC concentrations at 20 systematically selected filling stations in Ibadan North Local Government Area, Ibadan for 2 months using a Thermo Scientific pDR 1500 PM10 monitor and SF2000-TVOC meter. FEV1 and PEFR levels were measured in order to assess the effect of exposure to PM10 and TVOC on lung function of 100 filling station attendants using a PIKO-1 Electronic peakflow/FEV1 meter. Results Total mean PM10 concentrations (μg/m3) in the morning (43.7±16.5) and afternoon (27.8±7.9) were significantly lower (p<0.01) than the World Health Organization (WHO) guideline limit (50 μg/m3). Total mean TVOC concentrations (ppm) in the morning (12.0±3.4) and afternoon (5.6±2.4) were however significantly higher (p<0.01) than the Occupational Safety and Health Administration (OSHA) guideline limit (3 ppm). Mean FEV1 for filling station attendants was 1.63±0.39 and PEFR was 171.7±45.9. Conclusion Filling stations are hotspots for the emission of VOCs and PM10. However, filling station attendants in this study are at risk of exposure to high concentrations of VOCs but not PM10. FEV1 and PEFR values among filling station attendants were very low which could possibly be attributed to extended exposure to air pollutants. Regular medical examinations should also be conducted on filling station attendants in order to aid early detection of deviations in their health status.

scholarly journals Integrating latent classes in the Bayesian shared parameter joint model of longitudinal and survival outcomes

2020 ◽  
Vol 29 (11) ◽  
pp. 3294-3307
Author(s):  
Eleni-Rosalina Andrinopoulou ◽  
Kazem Nasserinejad ◽  
Rhonda Szczesniak ◽  
Dimitris Rizopoulos
Keyword(s):  
Cystic Fibrosis ◽  
Lung Function ◽  
Latent Class ◽  
Joint Model ◽  
Forced Expiratory Volume ◽  
Optimal Number ◽  
Latent Classes ◽  
Joint Models ◽  
Number Of Classes ◽  
Strength Of Association

Cystic fibrosis is a chronic lung disease requiring frequent lung-function monitoring to track acute respiratory events (pulmonary exacerbations). The association between lung-function trajectory and time-to-first exacerbation can be characterized using joint longitudinal-survival modeling. Joint models specified through the shared parameter framework quantify the strength of association between such outcomes but do not incorporate latent sub-populations reflective of heterogeneous disease progression. Conversely, latent class joint models explicitly postulate the existence of sub-populations but do not directly quantify the strength of association. Furthermore, choosing the optimal number of classes using established metrics like deviance information criterion is computationally intensive in complex models. To overcome these limitations, we integrate latent classes in the shared parameter joint model through a fully Bayesian approach. To choose the optimal number of classes, we construct a mixture model assuming more latent classes than present in the data, thereby asymptotically “emptying” superfluous latent classes, provided the Dirichlet prior on class proportions is sufficiently uninformative. Model properties are evaluated in simulation studies. Application to data from the US Cystic Fibrosis Registry supports the existence of three sub-populations corresponding to lung-function trajectories with high initial forced expiratory volume in 1 s ( FEV1), rapid FEV1 decline, and low but steady FEV1 progression. The association between FEV1 and hazard of exacerbation was negative in each class, but magnitude varied.

scholarly journals Lung function: population epidemiology and concordance in Australian children aged 11–12 years and their parents

BMJ Open ◽  
2019 ◽  
Vol 9 (Suppl 3) ◽  
pp. 53-62 ◽  
Author(s):  
Liam Welsh ◽  
Gayan Kathriachchige ◽  
Tahmeed Raheem ◽  
Anneke C Grobler ◽  
Melissa Wake ◽  
...  
Keyword(s):  
Lung Function ◽  
Population Sample ◽  
Correlation Coefficients ◽  
Cross Sectional Study ◽  
Forced Expiratory Volume ◽  
International Standards ◽  
Linear Regression Models ◽  
Cross Sectional ◽  
Parents And Children ◽  
Z Scores

ObjectivesTo describe the epidemiology of lung function in Australian children aged 11–12 years and their parents, and explore the degree of intergenerational concordance.DesignCross-sectional study (the Child Health CheckPoint) nested in the Longitudinal Study of Australian Children (LSAC).SettingAssessment centres in seven Australian cities and eight regional towns, February 2015 to March 2016. Families unable to attend a clinic appointment were offered a home visit during the same period.Participants1874 families (53% of all eligible) participated in the study. Lung function data were available for 1759 children aged 11–12 years and 1774 parents (1668 biological pairs).Outcome measuresParticipants completed spirometry with measures including forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC) and mid expiratory flow (MEF), converted to z-scores using Global Lung Initiative equations. Parent–child concordance was assessed using Pearson’s correlation coefficients and multivariable linear regression models. Survey weights and methods accounted for LSAC’s complex sampling, stratification and clustering within postcodes.ResultsAll lung function measures followed approximately normal distributions. Mean (SD) for FEV1, FVC and MEF z-scores in children were 0.33 (1.07), 0.83 (1.14) and −0.48 (1.09), respectively. Mean (SD) in parents were 0.28 (1.10), 0.85 (1.15) and −0.45 (1.10), respectively. Parent FEV1, FVC and MEF were associated with child lung function with significant positive correlation coefficients (0.22, 95% CI 0.17 to 0.26; 0.24, 95% CI 0.20 to 0.29; and 0.24, 95% CI 0.20 to 0.29, respectively).ConclusionsMean lung volumes were larger but with smaller airway size than international standards for both parents and children in this population sample. Modest associations between parent and child lung function highlight the potential for better identification of ‘at risk’ populations. Therefore, these findings may aid the development of health policy that aims to prevent the onset or limit the progression of lung disease.

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